Total Parenteral Nutrition

TOTAL PARENTERAL NUTRITION (TPN) is an intravenous administration of calories, nitrogen and other nutrients in sufficient quantities to achieve tissue synthesis and anabolism. It is originally, the term hyperalimentation was used to describe the procedure. Dudrick developed the technique for administering fluids for Parenteral Nutrition by way of the subclavian vein into the superior vena cava where the solution is diluted rapidly by the large volume of blood available, thus, minimizing the hypertonicity of the solution. Parenteral Nutrition is indicated for patients who are unable to ingest food due to carcinoma or extensive burns and patients who refuse to eat, as in the case of depressed geriatrics or young patients suffering from anorexia nervosa and surgical patients who should not be fed orally. Normal caloric requirement for adults is 2500 calories per day.

Formulation of TPN:

1. Protein which is main source of amino acids
2. Carbohydrates that provides energy
3. Lipid as a source of essential fatty acids
4. Electrolytes is for the proper enzymatic and energy conserving or expending reactions within the body. Examples are sodium, potassium, magnesium, calcium, chloride, phosphates and alike.
5. Traces of elements such as zinc, copper, selenium, chromium, iron, manganese, cobalt, molybdenum and others.
6. Vitamins for long-term therapy
7. Fluids (lastly to be mixed in the procedure)

Container
 Is made from silicone based bags that superseded by polyvinyl chloride and ethylvinyl acetate.

Storage Condition and Packaging
It is usually stored at a range from  2 to 6 degrees Celsius, but not allowed to be stored at room temperature for periods in excess of 12 to 24 hours required for administration. It is packaged in a polystyrene containers.